Combined Direct Repair and Inline Inflow Stenting in the Management of Aortoiliac Disease Extending Into the Common Femoral Artery

• Published in: Vascular and endovascular surgery Vol. 45; no. 3; pp. 274 - 282
• Main Authors: Sharafuddin, Melhem J., Kresowik, Timothy F., Hoballah, Jamal J., Nicholson, Rachael M., Sharp, William J.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-04-2011
• Subjects: Adult; Aged; Amputation; Aortic Diseases - mortality; Aortic Diseases - physiopathology; Aortic Diseases - surgery; Arterial Occlusive Diseases - mortality; Arterial Occlusive Diseases - physiopathology; Arterial Occlusive Diseases - surgery; Chi-Square Distribution; Combined Modality Therapy; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Endovascular Procedures - mortality; Female; Femoral Artery - physiopathology; Femoral Artery - surgery; Hemodynamics; Humans; Iliac Artery - physiopathology; Iliac Artery - surgery; Iowa; Kaplan-Meier Estimate; Limb Salvage; Logistic Models; Male; Middle Aged; Retrospective Studies; Risk Assessment; Risk Factors; Stents; Time Factors; Treatment Outcome; Vascular Patency; Vascular Surgical Procedures - adverse effects; Vascular Surgical Procedures - mortality; Iowa
• ISSN: 1538-5744; 1938-9116
• DOI: 10.1177/1538574410395037

Purpose: Describe a hybrid approach to simplify management of complex aortoiliac occlusive disease (AIOD) extending into the common femoral artery (CFA). Methods: Retrospective review of 56 patients who underwent hybrid management of AIOD extending into CFA between January 2003 and February 2007. Two distinct hybrid approaches were compared: Inline (iliac stenting continuous with an open CFA reconstruction, 38 limbs in 37 patients) and tandem (noncontiguous stenting of an upstream iliac segment, 20 limbs in 19 patients). The median follow-up duration was 15 ± 12 months in the inline group and 24 ± 12 months in the tandem group. Results: Technical success was achieved in all but 1 procedure. Clinical and hemodynamic responses to the interventions and limb loss rates were comparable in both groups. Survival table analysis showed no significant difference between inline and tandem reconstructions. Conclusions: Inline stenting represents a lesser invasive revascularization choice in complex AIOD with contiguous involvement of the CFA.